TY - JOUR AU - Andersen, Pia AU - Lindgaard, Anne-Mette AU - Prgomet, Mirela AU - Creswick, Nerida AU - Westbrook, Johanna I PY - 2009 DA - 2009/8/4 TI -医院病房医生和护士使用移动和固定电脑:JO - J Med Internet Res SP - e32 VL - 11 IS - 3kw -研究KW -多方法研究KW -观察研究KW -移动性KW -移动计算机KW -计算机KW -计算机硬件KW -医嘱输入系统KW -计算机医师医嘱输入系统KW -计算机提供者医嘱输入(CPOE) AB -背景:选择固定和移动计算设备的正确组合对系统规划者和实现者来说是一个重大的挑战。可作为此类决定基础的研究证据非常有限。目的:探讨医院病房中临床医师角色、临床任务与计算机硬件设备选择之间的关系。方法:观察27名护士和8名医生在悉尼一家主要教学医院的两个病房使用一系列计算设备访问计算机化的提供者命令输入系统，观察时间共80小时。观察员使用检查表来记录完成的临床任务、使用的设备和活动的地点。在观察期间也记录了实地记录。观察后进行半结构化访谈。评估了三种设备的物理属性——固定的个人电脑，轮子上的电脑(奶牛)和平板电脑。 Two types of COWs were available on the wards: generic COWs (laptops mounted on trolleys) and ergonomic COWs (an integrated computer and cart device). Heuristic evaluation of the user interfaces was also carried out. Results: The majority (93.1%) of observed nursing tasks were conducted using generic COWs. Most nursing tasks were performed in patients’ rooms (57%) or in the corridors (36%), with a small percentage at a patient’s bedside (5%). Most nursing tasks related to the preparation and administration of drugs. Doctors on ward rounds conducted 57.3% of observed clinical tasks on generic COWs and 35.9% on tablet PCs. On rounds, 56% of doctors’ tasks were performed in the corridors, 29% in patients’ rooms, and 3% at the bedside. Doctors not on a ward round conducted 93.6% of tasks using stationary PCs, most often within the doctors’ office. Nurses and doctors were observed performing workarounds, such as transcribing medication orders from the computer to paper. Conclusions: The choice of device was related to clinical role, nature of the clinical task, degree of mobility required, including where task completion occurs, and device design. Nurses’ work, and clinical tasks performed by doctors during ward rounds, require highly mobile computer devices. Nurses and doctors on ward rounds showed a strong preference for generic COWs over all other devices. Tablet PCs were selected by doctors for only a small proportion of clinical tasks. Even when using mobile devices clinicians completed a very low proportion of observed tasks at the bedside. The design of the devices and ward space configurations place limitations on how and where devices are used and on the mobility of clinical work. In such circumstances, clinicians will initiate workarounds to compensate. In selecting hardware devices, consideration should be given to who will be using the devices, the nature of their work, and the physical layout of the ward. SN - 1438-8871 UR - //www.mybigtv.com/2009/3/e32/ UR - https://doi.org/10.2196/jmir.1221 UR - http://www.ncbi.nlm.nih.gov/pubmed/19674959 DO - 10.2196/jmir.1221 ID - info:doi/10.2196/jmir.1221 ER -